According to research from the National Institute for Occupational Safety and Health (NIOSH), construction workers sustain more traumatic brain injuries (TBIs) than any other profession. In this article, we are going to focus on mild TBIs, also known as concussions. A concussion is the most common type of head or brain injury.

LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni

“Any blow to the head must be taken seriously. While most people will recover from concussion symptoms relatively quickly, continued monitoring of the person’s physical and mental health may be necessary,” says LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni. “It’s possible for even a mild concussion to cause long-term symptoms that require additional care.”

A study funded by the National Institutes of Health found that one in five people with a concussion may experience mental health symptoms, including post-traumatic stress disorder (PTSD) and depression for up to six months after being injured. In comparison, mental health conditions were reported in 8-12 percent of patients who were treated for orthopedic injuries like broken legs following their emergency room treatment. This study points to the importance of doctors monitoring patients with mild head injuries to ensure their mental well-being for months following their injury.

“These findings suggest that follow-up care after head injury, even for mild cases, is crucial, especially for patients showing risk factors for PTSD or depression,” said Dr. Murray B. Stein, a professor at the University of California San Diego and one of the authors of the study.

When It Comes to Your Brain, Mild Is Serious

A concussion occurs when a sudden bump, jolt or blow to the head makes the brain rapidly bounce and twist inside the skull. The resulting bruising and tearing of delicate tissues and nerve damage can cause confusion, disorientation and loss of consciousness. When symptoms resolve in less than 30 minutes and medical scans show normal brain function, the concussion is classified as “mild.” But what these test results don’t reveal are microscopic changes in the brain that can cause headaches, memory problems and mood swings in the weeks and months after a concussion. In some instances, these symptoms can affect every aspect of life, including making it difficult to go back to work.

Preventing Head Injuries

OSHA requires employers to provide workers with hard hats when there is a risk for head injury from dropped objects, impacts or electrical shock. However, construction employers should require workers to wear hard hats regardless of the job and should implement a good housekeeping program to further reduce risk for concussions and other head injuries. For example, same level falls are a leading cause of concussions in the workplace and frequently involve slippery, cluttered and unstable walking surfaces. Good housekeeping practices include:

• Cleaning spills immediately
• Mopping or sweeping debris from walking surfaces
• Removing obstacles and clutter from walkways
• Securing (tacking, taping, etc.) mats, rugs and carpets that do not lay flat
• Covering cables that cross walkways
• Keeping working areas and walkways well lit
• Assigning a worker to check the worksite for fall hazards daily

What Else Can Employers Do?

Most concussions are minor and don’t require calling 911, but employers should ensure workers are trained to recognize symptoms indicating a serious injury and that they know when emergency assistance is needed. Workers should also know what to do while waiting for help to arrive. For example, it’s best not to move the worker and if the worker is wearing a hard hat, to leave it on. Signs of a serious head injury include:

• Severe head or facial bleeding
• Bleeding or fluid leakage from the nose or ears
• Change in level of consciousness for more than a few seconds
• Black-and-blue discoloration below the eyes or behind the ears
• Cessation of breathing
• Confusion
• Loss of balance
• Slurred speech
• Seizures

Symptoms of a concussion may not appear for several hours or even several days. The injured employee should always be seen and cleared by a health care provider before returning to work. If you or someone you know sustains a blow to the head, report any symptoms to your health care provider, even if you think they’re not related.

LHSFNA Resources for LIUNA Signatory Contractors

The LHSFNA has developed a number of toolbox talks that can help LIUNA signatory contractors and other LIUNA affiliates educate workers about the risks of head injuries and the hazards of falls in construction. Topics include:

• Head Protection
• Fall Prevention: Guardrail Systems
• Holes in Flooring and Other Openings
• Ladder Safety
• Personal Fall Arrest Systems
• Scaffold Safety
• Slips, Trips and Falls

To order these or other materials, go to the Fund’s website at www.lhsfna.org and click on Publications.

[Janet Lubman Rathner]